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Defining failure after parathyroidectomy for primary hyperparathyroidism: case series

Published online by Cambridge University Press:  04 January 2011

S D Charlett ,
M Aye ,
S L Atkin  and
R J A England
S D Charlett*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Hull Royal Infirmary, UK
M Aye
Affiliation:
Department of Endocrinology, Hull Royal Infirmary, UK
S L Atkin
Affiliation:
Department of Endocrinology, Hull Royal Infirmary, UK
R J A England
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Hull Royal Infirmary, UK
*
Address for correspondence: Mr S D Charlett, C/O Secretary to Mr England Department of Otolaryngology, Hull Royal Infirmary, Anlaby Road, Hull HU3 2JZ, UK E-mail: sdcharlett@doctors.org.uk
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Abstract

Objective:

To identify the cause of operative failure in patients who have undergone parathyroid surgery for primary hyperparathyroidism.

Design:

Retrospective case review.

Participants:

Patients who had undergone a primary procedure for primary hyperparathyroidism between July 2003 and December 2007. Cases with incomplete post-operative serum calcium data were excluded.

Main outcome measure:

Operative failure was defined as failure to achieve normalisation of serum adjusted calcium levels post-operatively.

Results:

A total of 220 primary procedures were conducted over 4.5 years. Data were not available for 16 patients. Thirteen procedures (6.4 per cent) were considered failures, and these cases were individually reviewed and classified according to the reason for failure.

Conclusion:

Establishing the cause of failure following surgery for primary hyperparathyroidism can be a complex task. In some instances, diagnostic uncertainty remains despite detailed biochemical and radiological assessment. This paper outlines our approach to maximising the cure rate at primary surgery.

Keywords

Parathyroid HormonePrimary HyperparathyroidismHypercalcaemiaParathyroid AdenomaParathyroidectomy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 4 , April 2011 , pp. 394 - 398
Copyright
Copyright © JLO (1984) Limited 2011

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